Division of Gender, Sexuality and Health, New York State Psychiatric Institute, Columbia University, 1051 Riverside Drive, Unit 15, New York, NY, 10032, USA.
Department of Psychology, University of Pretoria, Hatfield, South Africa.
Arch Sex Behav. 2018 Nov;47(8):2481-2490. doi: 10.1007/s10508-018-1168-9. Epub 2018 Feb 20.
Unlike studies conducted in Western countries, two studies among Black South African men who have sex with men (MSM) found no support for the association between gender nonconformity and mental distress, even though gender-nonconforming men experienced more discrimination and discrimination was associated with mental distress (Cook, Sandfort, Nel, & Rich, 2013; Sandfort, Bos, Knox, & Reddy, 2016). In Sandfort et al., gender nonconformity was assessed as a continuous variable, validated by comparing scores between a categorical assessment of gender presentation (masculine, feminine, no preference). Using the same dataset, we further explored this topic by (1) testing differences between gender expression groups in sexual minority stressors, resilience factors, and mental distress; (2) testing whether the impact of elevated discrimination in the feminine group was counterbalanced by lower scores on other stressors or higher scores on resilience factors; and (3) exploring whether relationships of stressors and resilience factors with mental distress varied between gender expression groups. Controlling for demographics, we found several differences between the gender expression groups in the stressors and resilience factors, but not in mental distress. We found no support for the idea that the lack of differences in mental distress between the gender expression groups was a consequence of factors working in opposite directions. However, internalized homophobia had a differential impact on depression in feminine men compared to masculine men. In our discussion of these findings, we explored the meaning of our participants' self-categorization as it might relate to gender instead of sexual identities.
与西方国家的研究不同，两项针对南非黑人男男性行为者（MSM）的研究并未发现性别非规范与精神困扰之间存在关联，尽管性别非规范的男性经历了更多的歧视，而歧视与精神困扰有关（Cook、Sandfort、Nel 和 Rich，2013；Sandfort、Bos、Knox 和 Reddy，2016）。在 Sandfort 等人的研究中，性别非规范被评估为一个连续变量，通过比较性别表现（男性化、女性化、无偏好）的分类评估中的分数来验证。使用相同的数据集，我们通过以下方式进一步探讨了这个主题：（1）测试性别表达群体在性少数群体应激源、适应因素和精神困扰方面的差异；（2）测试在女性群体中升高的歧视是否被其他应激源的较低分数或适应因素的较高分数所抵消；（3）探索应激源和适应因素与精神困扰之间的关系在性别表达群体之间是否存在差异。在控制人口统计学因素的情况下，我们发现性别表达群体在应激源和适应因素方面存在差异，但在精神困扰方面没有差异。我们没有发现支持这样一种观点的证据，即性别表达群体之间在精神困扰方面没有差异是由于作用方向相反的因素造成的。然而，内化的恐同症对女性化男性的抑郁产生了不同于对男性化男性的影响。在我们对这些发现的讨论中，我们探讨了参与者自我分类的含义，因为它可能与性别而不是性身份有关。
